Hello Reader

Optimizing for longevity is not about trying to live forever.

Longevity is a combination of a maximized lifespan - being around for as long as possible - and an extended healthspan - increasing the number of quality years keeping sickness at bay.

It is completely achievable by anyone who decides to take control of their lifestyle, since at least 5 of the most deadly conditions are preventable.

There is one way to know how long and how well you may live, without having to wait until you're old enough to know if your efforts paid off: using predictive markers.

Key performance indicators are used to measure company's success.
Similarly, we need KPIs to see what is working and not working in our strategy when following a longevity roadmap.

What markers should you include in your personal dashboard for longevity?

We'll get into this today for part 1 and next week for part 2.

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The life meter: the 3 non-negotiable markers for longevity

There are 3 markers that are well established as predictive of longevity:

• Cardio-vascular fitness as measured by VO2 max
• Muscle strength
• Muscle mass (body composition)

They reflect what we have in the tank, how much physical capital we have as we age : they tell us how easy or hard it will be to perform day-to-day activities like walking up the stairs, carrying groceries and keeping up with and picking up grand-kids.

They also give us more confidence that our mind will perform.

These markers are non-negotiable, because they are the most predictive of longevity, evidence-based and relatively easy to get.

You don't need a physician to access to these tests, which I personally think is empowering.
We absolutely need doctors to interpret complex lab data. But they can also sometimes act as gate-keeper of our health.
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Here is what I call the "Life meter" for 1UP, the extra-life coaching program: a unique longevity dashboard:

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I have created a life meter bar graph that shows my potential for extra life (left) compared to my current levels of fitness (right).

The goal for longevity is to close the gap between current and potential for extra life.

In my case, this has to be done by increasing strength, building muscle mass and increasing VO2 max.

Measures of strength are on my dashboard: I have included grip strength, how long I can dead hang, how much I can lift in a farmer carry and how heavy I deadlift.
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My VO2 max is shown by the yellow dot on the line graph (38 mL/kg/min). The line graph shows the levels in VO2 max from low to elite for women in my age group.

My body composition displays muscle mass and percentage of body fat. I plan to update every quarter, except for VO2 max that will be measured once a year.

I have included space for progress pictures in my dashboard because it tells a story other things don't.

Progress picture is a great motivator when you can overcome the initial discomfort, from looking at your starting point.
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Full disclosure: in my case, I even felt some disgust seeing certain parts of my body I don't usually see in the mirror. It was eye-opening and quite vulnerable to make my pictures available publicly. But I have made a promise to myself that in one year from now, this will be the most powerful image.
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Everyone signing up for 1UP will get started with putting their life meter together.
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I have made the life meter available as a template for you to add your data to it and get your own Life meter started. Use this link.
This is the first time I use this template feature and to be honest, I'm not sure it will work. Let me know if you're having difficulties with it.

Let me know if you use the life meter template, I'd love to hear about it.
Caveat: VO2 max levels from low to elite reflect levels for women 40-49 years old.

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Your ageotype

We all age differently. That's something we can all observe. Some research may have found the mechanism.

An interesting study from 2020 done at Stanford has found that we may age along 4 main biological pathways that the authors call "ageotypes": metabolic, immune, hepatic (liver), nephrotic (kidney).

The study only had 43 participants. One of them was found to have a cardiac ageotype as well. So there may be more identifiable pathways.

These pathways emerged from testing huge numbers of markers, some very common, some only available in a research lab.
​The study also showed that these markers, and the way people age, responded to lifestyle changes such as diet and exercise.

Measure were taken 5 times in a year to establish trends.

This can have some specific applications in a longevity dashboard:

• Metabolic agers
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  Metabolic agers may be at higher risk for diabetes and other metabolic diseases.
  Eating habits, meal timing and composition, sleep, stress and hormones as well as body composition (proportion of fat and muscle tissue) determine our metabolic rates.
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  The clinical markers assessed in the study are some you could get tested with the help of a physician or by ordering your own lab if that's an option for you: Hemoglobin A1c, fasting blood glucose, cholesterol and oral glucose tolerance test.
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  How to spot a metabolic agers: they may be overweight, have trouble regulating appetite, be pre-diabetic or diabetic.
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  What it means for your longevity dashboard: metabolic agers should pay close attention to their insulin sensitivity and relationship to sugar.
  They could benefit from exercising and controlling their diet.
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• Immune agers
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  Immune agers are people who have higher levels of inflammation and an over-active immune system.
  C-reactive protein (C-RP) is a marker of generalized inflammation, although subject to high levels of variability.
  Immune agers may have elevated cytokines, interleukines and C-RP.
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  How to spot an immune ager: they may have reactive skin, joint pain or auto-immune conditions. Leaky gut also over-stimulates the immune system (trouble digesting, frequent diarrhea).
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  Immune agers would probably benefit from eating diets that limit inflammatory food, including experimenting with auto-immune diets, developing stress-management skills and controlling their environment to limit exposure to toxins.
  They could benefit from using the sauna more often to detox, and support their microbiome to eliminate.
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• Hepatic agers
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  Hepatic agers are at higher risk of liver disease.
  You may have seen alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) in some of your medical check ups. They reflect liver function.
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  How to spot a hepatic ager: they may have yellowing of the skin or the white of the eyes, swelling in the legs and ankles, increased blood pressure. People who drink alcohol regularly are at higher risk for liver damage.
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  Hepatic agers may benefit from reducing alcohol intake and support blood flow with exercise and foods that stimulate the production of nitric oxide.
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• Nephrotic agers
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  Nephrotic agers tend to have more issues with kidney functions.
  Creatinine, urea, electrolytes or protein in urine are markers commonly used to evaluate kidney function.
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  How to spot a nephrotic ager: they may go to the bathroom more, or less, may have muscle cramps, high blood pressure.
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  Nephrotic agers may benefit from drinking more water and monitor kidney function and blood pressure more closely.

The ageotypes were observed in a very small cohort of people. More research needs to be done to validate these observations. So please take this with a grain of salt.

And of course, I am not a medical doctor, so this is not intended as medical advice. I am here reporting research from Dr. Snyder at Stanford and using my extensive knowledge of human biology as a scientist with a PhD in life sciences to give you some food for thoughts.

I hope this information will encourage you to pay attention to signals your body may be sending to you right now.

I grew up in a family in which we did not go to the doctor. Either by fear that they may find something, or as a byproduct of a deep and unconscious death wish, neglect was the rule.

I used to be the type of person that completely ignores red flags: keep going, brush things off, never test, never stop to check in. I was too tough to pay attention. I had important things to do and could not afford to stop.

As a result, I've gone through cycles of burn out and used substances to cope. It has costed me a lot.

I'm often told by friends in their 50s that they wish they had slowed down, that they wish they had paid attention.

May this be your friendly reminder to attend to your health.

I don't want this to cost you.

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Next week, I'll send part 2 on these markers for your personal longevity dashboard: we'll talk about biological age tests and your family history for risk factors.

Take good care,

Chat next week.

Jihane

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